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Change Requests for ASC X12 Work Products

1285

999 AK103 Usage When GS08 Is In Error

Submitted: 6/3/2013

Primary Work Group: None -

Business Reason

A compliant 999 cannot be constructed and sent to the requester when data element GS08 contains syntax errors because the AK103 data element contains that value in error. The industry has a need to report 999 errors in a compliant manner that will not be rejected by their trading partner's validation engines. These situations have become known as "GIGO" (Garbage In, Garbage Out) errors within the industry, and several of the larger software vendors have had difficulty coming up with a way in which to handle them.

Description

In a 5010 999 response, data element AK103 should contain the value of GS08 from the 270 request. The definition for AK905=6 reads: “Group control number violates syntax,” which is the appropriate error returned if GS08 is missing, blank, greater than 12 characters, or is using a special character that is not supported by the information source. This error, however, cannot be returned without creating a non-compliant 999 because AK103 has the same syntax rules as GS08.

This issue was fully vetted with TG2/WG1 and X12C in 2011, at which time it was agreed that it would need to be addressed in a future version. General X12 guidance from X12C has been to follow the “up one level” error handling rule, which states that if a proper error cannot be constructed at a given level, create a properly formatted error one level above the error which cannot be properly constructed. For example, if a proper 999 cannot be constructed, create a TA1 error instead. Following this guidance, a TA1 error is now being returned with data element TA105=024 for the given scenario, which reads "Invalid Interchange Content (e.g., Invalid GS Segment).” This error response is misleading, non-descript, and should not be sent when there is a specific 999 error code that can pinpoint the error.

HIPAA legislation does not mandate that a 999 error response be returned, and therefore a payer could return no response if this situation occurs. This is not an option in the real-time 270/271 environment, where either a valid 271 or an error response must be generated.

Suggested possible solution: Change the note accompanying AK103 to state that the value of the inbound GS08 should be used if 1 – 12 AN chars, but if invalid offer a default value to include in this field.